Laboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genova, IRCCS San Martino Polyclinic, 16132 Genova, Italy.
Pneumology Unit, IRCCS San Martino Polyclinic, 16132 Genova, Italy.
Nutrients. 2021 Feb 24;13(3):717. doi: 10.3390/nu13030717.
Vitamin D deficiency is frequently reported in patients with SARS-CoV-2 infection. The aim of this study was to correlate the 25OH-Vitamin D serum concentrations with clinical parameters of lung involvement, in elderly patients hospitalized for SARS-CoV-2 infection. Sixty-five consecutive COVID-19 patients (mean age 76 ± 13 years) and sixty-five sex- and age-matched control subjects (CNT) were analyzed. The following clinical parameters, including comorbidities, were collected at admission: type of pulmonary involvement, respiratory parameters (PaO, SO, PaCO, PaO/FiO), laboratory parameters (including 25OH-vitamin D, D-dimer, C-reactive protein). Significantly lower vitamin D serum levels were found in COVID-19 patients than in CNT (median 7.9 vs 16.3 ng/mL, = 0.001). Interestingly, a statistically significant positive correlation was observed between vitamin D serum levels and PaO ( = 0.03), SO ( = 0.05), PaO/FiO ( = 0.02), while a statistically significant negative correlation was found between vitamin D serum levels and D-dimer ( = 0.04), C-reactive protein ( = 0.04) and percentage of O in a venturi mask ( = 0.04). A negative correlation was also observed between vitamin D serum levels and severity of radiologic pulmonary involvement, evaluated by computed tomography: in particular, vitamin D was found significantly lower in COVID-19 patients with either multiple lung consolidations ( = 0.0001) or diffuse/severe interstitial lung involvement than in those with mild involvement ( = 0.05). Finally, significantly lower vitamin D serum levels were found in the elderly COVID-19 patients who died during hospitalization, compared to those who survived (median 3.0 vs 8.4 ng/mL, = 0.046). This study confirms that 25OH-vitamin D serum deficiency is associated with more severe lung involvement, longer disease duration and risk of death, in elderly COVID-19 patients. The detection of low vitamin D levels also in younger COVID-19 patients with less comorbidities further suggests vitamin D deficiency as crucial risk factor at any age.
维生素 D 缺乏症在 SARS-CoV-2 感染患者中经常被报道。本研究的目的是在因 SARS-CoV-2 感染住院的老年患者中，将 25OH-维生素 D 血清浓度与肺部受累的临床参数相关联。 分析了 65 例连续的 COVID-19 患者（平均年龄 76±13 岁）和 65 名性别和年龄匹配的对照患者（CNT）。入院时收集了以下临床参数，包括合并症：肺部受累类型、呼吸参数（PaO、SO、PaCO、PaO/FiO）、实验室参数（包括 25OH-维生素 D、D-二聚体、C 反应蛋白）。COVID-19 患者的维生素 D 血清水平明显低于 CNT（中位数 7.9 vs 16.3ng/ml，=0.001）。有趣的是，维生素 D 血清水平与 PaO（=0.03）、SO（=0.05）、PaO/FiO（=0.02）呈正相关，而与 D-二聚体（=0.04）、C 反应蛋白（=0.04）和文丘里面罩中的 O 百分比（=0.04）呈负相关。维生素 D 血清水平与 CT 评估的肺部受累严重程度呈负相关：特别是，在 COVID-19 患者中，有多个肺实变（=0.0001）或弥漫性/严重间质肺受累的患者中，维生素 D 明显低于仅有轻度受累的患者（=0.05）。最后，与存活患者相比，住院期间死亡的老年 COVID-19 患者的维生素 D 血清水平明显较低（中位数 3.0 vs 8.4ng/ml，=0.046）。 本研究证实，在老年 COVID-19 患者中，25OH-维生素 D 血清缺乏与更严重的肺部受累、疾病持续时间更长和死亡风险相关。即使在合并症较少的年轻 COVID-19 患者中也发现了低维生素 D 水平，这进一步表明维生素 D 缺乏是任何年龄段的关键危险因素。
